看護師の道徳的感受性とその関連要因：精神科看護師と一般科看護師との比較検討

Moral sensitivity of nurses and factors related to the moral sensitivity: Comparing psychiatric nurses and nurses in general wards

　目的：精神科と一般科看護師の道徳的感受性とその関連要因について比較し、それぞれの特徴を明らかにする。方法：中部地方の1精神科病院200名、1総合病院577名の看護師に自記式質問紙調査を実施した。道徳的感受性質問紙日本語版2018（前田ら2019、以下「J-MSQ2018」とする）、個人要因、職場環境要因、看護師の自己像を尋ね、J-MSQ2018を従属変数として重回帰分析を実施した（p＜0.05）。結果：J-MSQ2018に欠損のない555（有効回答率71.4％）を分析対象とした。自由度調整済み決定係数は精神科0.16、一般科0.24であった。一般科は、「個人要因」の男性、「看護師の自己像」の項目と関連があった。「道徳的強さ」は、両科共に自尊感情との間に関連がみとめられた。結論：一般科は「看護師の自己像」の側面での支援が、両科共に自尊感情低下防止が看護師支援に寄与しうることが示唆された。

　Objectives: This study aims to identify the characteristics of moral sensitivity among nurses of psychiatric and general wards by comparing factors related to the moral sensitivity of the nurses of the two different wards.

　Methods: A self-rated questionnaire survey inquiring about personal factors, work environment factors, and self-image as a nurse was administered to 200 nurses at a psychiatric hospital and 577 nurses at a general hospital in the Chubu region of Japan. Using the Japanese version of the Moral Sensitivity Questionnaire 2018 (J-MSQ2018, Maeda et al., 2019) as the dependent variable (p＜0.05), multiple regression analysis was performed.

　Results: We analyzed 555 valid responses (71.4％) that completed all the items in the J-MSQ2018. (R²: 0.16 for psychiatry; 0.24 for general word nurses). General ward nurses showed statistically significant relationships with items of “personal factors” (in males) and “self-image as a nurse”. Both ward nurses showed a significant positive relationship between moral strength and self-esteem.

　Conclusions: Providing support related to the “self-image as a nurse” among general ward nurses may contribute to moral sensitivity, and prevention of self-esteem decline may contribute to the improvement of moral strength in nurses in both wards.